African Americans make up about 13 percent of the population, but they account for 35 percent of people with kidney failure in the United States. According to the National Kidney Foundation, African Americans are nearly three times more likely than Whites to have kidney failure.

Low income has also been linked to higher incidents of kidney disease. Kidney disease usually progresses to kidney failure. There may be no symptoms until the kidneys are severely damaged and dialysis or transplant are needed.

Along with African-Americans, Native Americans, Hispanic, Asian Americans and Pacific Islanders are at greater risk for Chronic Kidney Disease (CKD).

The kidneys remove waste and excess fluid through the urine. Waste removal involves a highly complex process of excretion and re-absorption balance.

The kidneys regulate, sodium, potassium and acid content. The kidneys produce hormones that affect other organ functions. One of these hormones stimulates red blood cell production. Another hormone helps regulate blood pressure and calcium breakdown for the body to use.

High blood pressure and diabetes are the leading causes of kidney disease/failure among African Americans. High blood pressure increases the force against artery walls and damages the kidneys. When the body doesn’t make enough insulin or use normal amounts of insulin properly, high blood sugars damage the kidneys.

Glomerulonephritis causes inflammation in the kidney’s filtering system. This inflammation may occur with the diagnosis of strep throat. Once resolved, kidney disease may develop slowly and cause progressive, irreversible kidney disease.

Polycystic kidney disease is the most common inherited kidney disease.  This disease is characterized by the formation of cysts on the kidneys that cause serious damage and possible kidney failure.

Certain drugs may cause kidney disease. The long-term use of over the counter pain relievers, like Aleve and Ibuprofen, can damage the kidneys. Some prescription medications and street drugs like heroin and crack can lead kidney failure.

Chronic kidney disease occurs when decreased kidney function occurs for more than three months.

Early detection and treatment of CKD are vital to prevent disease progression and kidney failure.

Detection of kidney disease includes testing the urine for protein.  However, protein in the urine may also occur with fever or heavy exercise. An elevated blood creatinine level, age, race, gender and GFR (glomerular filtration rate) are used to diagnose kidney disease.

Symptoms of CKD may include increased urination, especially at night. Fatigue, weakness, difficult or painful urination, swelling of the face, puffy hands, feet or abdomen may indicate disease. An elevated blood creatinine and BUN also occur when kidney disease is present.

There are five stages of CKD. The GFR value determines the stage of the disease and how well the kidneys are cleaning the blood. A normal GFR is between 90-120.

In stage 5, ESRD (end stage renal disease), the GFR is less than 15 and dialysis or transplant are required. Fatigue associated with anemia, decreased appetite, nausea & vomiting, abnormal hormone levels, high blood pressure, swelling of body parts and shortness of breath are present.

Dialysis- prescribed by a physician, is used to cleanse the body of unwanted toxins(poisons), waste products and excess body fluid. Dialysis replaces some kidney function and can help prolong life. Along with medication, dietary changes and proper care, an individual receiving dialysis can live a relatively normal life.

The National Kidney Foundation at 1-800-622-9010 and Fresenius Medical Care at 1-800-377-4607 can provide additional information, resources and support about African Americans and kidney disease.

Marcia Jackson Is a retired RN and educator living in the Baltimore area.